May 10, 2012

Epilepsy: Why Drug Reaction Matters

(Ivanhoe Newswire) —They say first impressions are lasting impressions--and for people with epilepsy the way they respond to their first drug treatment could tell doctors a lot about the likelihood of future seizures.

"Our research shows a pattern based on how a person responds to initial treatment and specifically, to their first two courses of drug treatment," study author Patrick Kwan, M.D., Ph.D., with the University of Melbourne in Australia was quoted as saying.

For the study, researchers followed nearly 1,100 people from Scotland with newly diagnosed epilepsy. The participants were followed for as long as 26 years after being given their first drug therapy. Participants were considered seizure-free if they had no seizures for at least a year without changes to their treatment. If they had further seizures, a second drug was either given alone or added to the first. If the seizures continued, a third drug was selected, and the process continued for up to nine drug regimens.

The study found that half of the people were seizure-free after the first drug tried, 13 percent were seizure-free after the second and 4 percent were seizure-free after the third drug regimen tried. Less than two percent of the participants stopped having seizures on additional drug treatment courses up to the seventh one tried, and none became seizure-free after that.

The research also found that 37 percent of people in the study became seizure-free within six months of treatment, while another 22 percent became seizure-free after more than six months of starting treatment. By the end of the study, 749 people were seizure-free and 678 people were on only one drug. Researchers say the results were independent of the age when the person had the first seizure or the type of epilepsy.

"A person who doesn't respond well to two courses of epilepsy drug treatment should be further evaluated to verify an epilepsy diagnosis and to identify whether surgery is the best next step," Patricia E. Penovich, M.D., with the Minnesota Epilepsy Group PA and the University of Minnesota School of Medicine in St. Paul, Minn., and a Fellow with the American Academy of Neurology was quoted as saying.

SOURCE: Neurology, May 2012